Prospective study of methotrexate treatment for rheumatoid arthritis treated legitimately according to the government recommended 8 mg/week dose
Prospective study of methotrexate treatment for rheumatoid arthritis treated legitimately according to the government recommended 8 mg/week dose
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DOI：
10.1007/s10165-009-0205-x
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发表时间：
2009-12-01
影响因子：
2.2
通讯作者：
Shiozawa, Shunichi
中科院分区：
文献类型：
--
作者：
Hashiramoto, Akira;Shiozawa, Kazuko;Shiozawa, Shunichi
根据日本政府推荐剂量8 mg/周，对甲氨蝶呤（MTX）治疗类风湿关节炎患者的临床疗效进行前瞻性评价。共有176名在Konan Kakogawa医院和神户大学医院就诊的活动性RA患者被纳入研究。研究开始时，患者的评分为2.0 +/- A 1.1级，x线分期为2.6 +/- A 1.0级。MTX治疗的效果通过美国风湿病学会（ACR）核心集、28个关节疾病活动评分（DAS28）和欧洲抗风湿病联盟（EULAR）反应标准进行评估。采用改进的夏普方法评价x线片。ACR核心组的临床体征和症状改善持续24个月（p < 0.05）。在12个月和24个月的评估中，ACR20/50/70和DAS28也有所改善。然而，130名患者中有82名（63.5%）在MTX治疗24个月时发现无反应，根据EULAR反应标准进行评估。x线检查显示，尽管接受了治疗，关节破坏仍在继续。因此，按照日本8毫克/周方案进行的长期MTX治疗似乎对RA的症状和体征有利；然而，它显然是不够的，不能阻止风湿性关节破坏的进展。
Clinical squeal of the treatment of rheumatoid arthritis patients with methotrexate (MTX) according to the Japanese government recommended dose of 8 mg/week was evaluated prospectively. A total of 176 patients with active RA attending Konan Kakogawa Hospital and Kobe University Hospital were enrolled. Patients' profile at the start of study was Class 2.0 +/- A 1.1 and X-ray stage 2.6 +/- A 1.0. The effects of MTX treatment were evaluated by the American College of Rheumatology (ACR) core set, disease activity score of 28 joints (DAS28), and European League Against Rheumatism (EULAR) response criteria. A modified Sharp method was used to evaluate the radiographs. The improvement in the clinical signs and symptoms of the ACR core set was maintained for a 24-month period (p < 0.05). The ACR20/50/70 and DAS28 were also improved at the 12- and 24-month assessments. However, 82 of 130 patients (63.5%) were found to be nonresponders at 24 months of MTX therapy, as evaluated by EULAR response criteria. The X-ray study showed that joint destruction progressed despite the treatment. Thus, long-term MTX treatment performed in accordance with the Japanese 8 mg/week regimen appears to be favorable in terms of the signs and symptoms of RA; however, it is clearly insufficient for and cannot halt the progression of rheumatic joint destruction.